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Value of radial probe endobronchial ultrasound-guided transbronchial biopsy and computer tomography-guided transthoracic needle aspiration in the diagnosis of peripheral pulmonary lesions.

Abstract Computer tomography-guided transthoracic needle aspiration (CT-TTNA) is a minimally invasive technique for sampling peripheral lung lesions. Radial endobronchial ultrasound-guided transbronchial biopsy (rEBUS-TBB) is an alternative. The present study analyzed and compared rEBUS-TBB and CT-TTNA in the diagnosis of peripheral pulmonary lesions (PPL).Clinical data of 513 patients with PPL who underwent an rEBUS-TBB or CT-TTNA examination were analyzed retrospectively. The positive diagnostic rate, complication rate, and influencing factors of the 2 methods were compared.The positive diagnostic rate and complication rate were significantly higher in CT-TTNA than rEBUS-TBB (P = .001; P < .001, respectively). The rEBUS-TBB group showed a higher positive diagnostic rate in larger lesions (>2 cm) than in smaller (≤2 cm) (P = .012), and was lower in the lesions proximal to the chest wall than those distally located (P = .046); no significant difference was observed in the different pulmonary segments (P = .109). In the CT-TTNA group, the positive diagnostic rate in larger lesions did not differ significantly than the smaller lesions (P = .05); it differed significantly in different segments (P = .044). The incidence of pneumothorax was lower in lesions proximal to the chest wall than those located distally (P = .037). In the rEBUS-TBB group, the success rate of the exploration and biopsy of the lesions was 87.4%; the rate of exploration of larger lesions and with bronchial sign was higher than smaller lesions and without bronchial sign (P < .001; P < .001, respectively) while that of lesions close to the chest wall was lower than those distally located (P = .006).rEBUS-TBB and CT-TTNA are effective and safe in the diagnosis of PPL. The positive diagnostic rate of CT-TTNA is higher than rEBUS-TBB. The incidence of pneumothorax in CT-TTNA is higher than rEBUS-TBB. CT-TTNA is selected for smaller lesions close to the chest wall; rEBUS-TBB is used for lesions larger, distal from the chest wall or with a bronchial sign.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28834894
OWN - NLM
STAT- MEDLINE
DA  - 20170823
DCOM- 20170912
LR  - 20170912
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 34
DP  - 2017 Aug
TI  - Value of radial probe endobronchial ultrasound-guided transbronchial biopsy and
      computer tomography-guided transthoracic needle aspiration in the diagnosis of
      peripheral pulmonary lesions.
PG  - e7843
LID - 10.1097/MD.0000000000007843 [doi]
AB  - Computer tomography-guided transthoracic needle aspiration (CT-TTNA) is a
      minimally invasive technique for sampling peripheral lung lesions. Radial
      endobronchial ultrasound-guided transbronchial biopsy (rEBUS-TBB) is an
      alternative. The present study analyzed and compared rEBUS-TBB and CT-TTNA in the
      diagnosis of peripheral pulmonary lesions (PPL).Clinical data of 513 patients
      with PPL who underwent an rEBUS-TBB or CT-TTNA examination were analyzed
      retrospectively. The positive diagnostic rate, complication rate, and influencing
      factors of the 2 methods were compared.The positive diagnostic rate and
      complication rate were significantly higher in CT-TTNA than rEBUS-TBB (P = .001; 
      P &lt; .001, respectively). The rEBUS-TBB group showed a higher positive diagnostic 
      rate in larger lesions (&gt;2 cm) than in smaller (&lt;/=2 cm) (P = .012), and was
      lower in the lesions proximal to the chest wall than those distally located (P = 
      .046); no significant difference was observed in the different pulmonary segments
      (P = .109). In the CT-TTNA group, the positive diagnostic rate in larger lesions 
      did not differ significantly than the smaller lesions (P = .05); it differed
      significantly in different segments (P = .044). The incidence of pneumothorax was
      lower in lesions proximal to the chest wall than those located distally (P =
      .037). In the rEBUS-TBB group, the success rate of the exploration and biopsy of 
      the lesions was 87.4%; the rate of exploration of larger lesions and with
      bronchial sign was higher than smaller lesions and without bronchial sign (P &lt;
      .001; P &lt; .001, respectively) while that of lesions close to the chest wall was
      lower than those distally located (P = .006).rEBUS-TBB and CT-TTNA are effective 
      and safe in the diagnosis of PPL. The positive diagnostic rate of CT-TTNA is
      higher than rEBUS-TBB. The incidence of pneumothorax in CT-TTNA is higher than
      rEBUS-TBB. CT-TTNA is selected for smaller lesions close to the chest wall;
      rEBUS-TBB is used for lesions larger, distal from the chest wall or with a
      bronchial sign.
FAU - Zhang, Qiudi
AU  - Zhang Q
AD  - Department of Respiratory Medicine, The Third Affiliated Hospital of Soochow
      University (Changzhou First People's Hospital), Changzhou, Jiangsu, China.
FAU - Zhang, Sujuan
AU  - Zhang S
FAU - Xu, Xiong
AU  - Xu X
FAU - Xu, Qianqian
AU  - Xu Q
FAU - Zhou, Jun
AU  - Zhou J
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biopsy, Needle/adverse effects/*methods
MH  - Endosonography/adverse effects/*methods
MH  - Female
MH  - Humans
MH  - Image-Guided Biopsy/adverse effects/*methods
MH  - Lung/pathology
MH  - Lung Diseases/*pathology
MH  - Male
MH  - Middle Aged
MH  - Pneumothorax/etiology
MH  - Retrospective Studies
MH  - Tomography, X-Ray Computed/*methods
MH  - Young Adult
PMC - PMC5572016
EDAT- 2017/08/24 06:00
MHDA- 2017/09/13 06:00
CRDT- 2017/08/24 06:00
AID - 10.1097/MD.0000000000007843 [doi]
AID - 00005792-201708250-00031 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Aug;96(34):e7843. doi: 10.1097/MD.0000000000007843.